Provider Demographics
NPI:1790970895
Name:AULD, KERRY SELMYHR
Entity Type:Individual
Prefix:
First Name:KERRY
Middle Name:SELMYHR
Last Name:AULD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13685 LAS PALMAS DR
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33774-4632
Mailing Address - Country:US
Mailing Address - Phone:727-596-1701
Mailing Address - Fax:
Practice Address - Street 1:13685 LAS PALMAS DR
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33774-4632
Practice Address - Country:US
Practice Address - Phone:727-596-1701
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-11
Last Update Date:2007-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist